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In interviews with NBC News, many federal workers shared stories of overwhelming stress, personal crises, rapid weight loss, panic attacks and more By Natasha Korecki The call that would upend his life came 11 years ago. His daughter had hanged herself; she was now on life support. He rushed to her bedside, but eventually the time came when the machine would be turned off. The father placed his hand on his daughter’s chest, found her heartbeat and willed her to push through. Her heart slowed and slowed and slowed. Then it stopped. She was gone. The anguish crashed down on him like a tank, compounding the despair he carried after another suicide 14 years earlier. He and his brother had found his father, a Vietnam War veteran, dead from a self-inflicted gunshot wound. In an interview, the 54-year-old suicide prevention case manager with the Department of Veterans Affairs painfully recalled his agonizing journey, which also included beating cancer, as he grappled with a new crisis of his own. The world he turned to for salvation — returning to school at age 46, specifically to become a social worker so he could work in suicide prevention with veterans — was now in turmoil. Like the roughly 2 million workers across the federal government, he is watching his colleagues and the veterans he’s trying to help lose their livelihoods or weather a barrage of messages that federal workers have no value — often coming directly from the president and the people he has empowered. The White House did not return a request for comment. “When you have a purpose in life and you found your thing, and then all of a sudden it’s being destroyed — you lose all hope,” the suicide prevention manager said, his voice fading. The federal worker, like others quoted in this story, asked that he remain anonymous for fear of reprisal. “I hurt for everybody who’s impacted by it, you know? I mean, I hate to say it, but I work in suicide prevention and I had thoughts. I’ve had thoughts of not wanting to be here anymore.” NBC News spoke with 20 federal employees across agencies. Spanning the country, these workers lost their jobs, watched co-workers lose them or endured what amounted to a Goliath joyously stomping on David. In interviews, federal workers — many of whom are veterans — told of overwhelming stress, personal crises, suicidal ideation, rapid weight loss, prolonged lack of sleep, panic attacks and visiting the emergency room after a mental breakdown. They’re facing bombardment from every angle, some showing screenshots to reporters of offensive messages delivered over text and social media, which in turn echo misinformation that billionaire Elon Musk has elevated on his X platform — for example that federal workers are lazy, that they themselves are a source of waste and fraud, and that they don’t bother to come to the office. Some, particularly veterans or those who assist veterans, expressed fury they’re being denigrated by Musk and a president who never wore a military uniform. Trump, a president for whom some of them voted, even posted an insulting meme about federal workers on his Truth Social account that showed an image of the cartoon character SpongeBob holding a list. It read, “Got done last week,” an apparent reference to Musk’s request of federal workers that they send an email pointing to five things they did at work. “Cried about Trump. Cried about Elon. Made it into the office for once. Read some emails. Cried about Trump and Elon some more.” Sarah Boim, a 38-year-old who was fired from her job with the Centers for Disease Control and Prevention in Atlanta, said she grew so distraught that her therapist told her to find a psychiatrist and immediately get on an antidepressant. Boim said she and her husband cannot pay their mortgage on one income and she is desperately searching for work. “Your career is ripped away from you, with no money to move forward,” Boim said. “I have bipolar. It’ll mess up my life if I have an episode. So we’re just trying to be really careful. I’m hearing stuff like that across the agency.” “I knew there would be reorganization. I wasn’t expecting this level of chaos,” Boim added. “Taking a sledgehammer approach and having an unelected billionaire in my email is just insane. What are his qualifications for doing this? The government is not a startup; we have been in business since 1776.” Some who voted for Trump said they regret believing him as a candidate when he said he rejected Project 2025, whose co-author Russell Vought said he wanted to put federal civil servants “in trauma.” Once in office, Trump tapped Vought to lead the Office of Management and Budget, a powerful post. “We want the bureaucrats to be traumatically affected,” Vought said in a speech in the lead-up to the Nov. 4 election. “When they wake up in the morning, we want them to not want to go to work because they are increasingly viewed as the villains.” So far, they say, Vought is succeeding. One Department of Defense employee who did two tours in Iraq said his post-traumatic stress disorder was triggered to the point that he called a suicide hotline, then visited an emergency room at a veterans hospital. The employee said he and colleagues felt unspeakable frustration and anger after relentless mocking by Musk that was supported by Trump, who he said appeared to be delighting in the distress of his own workforce. The worker said his episode emerged the weekend Musk made a display of joyously lifting a chain saw while appearing at a conservative conference. In that same period, employees were deluged with messaging from Musk’s Department of Government Efficiency, or DOGE, that ranged from termination notices to confusing emails that were often contradicted by supervisors. “It’s not about the layoffs. It’s about a dehumanization of who we are and what we do,” he said, noting he voted for Trump because he liked what the president did in his first stint in office. Now, he said, he carries guilt over his Trump vote after he watched co-workers and other veterans at the emergency room. “We don’t do it for the applause. We do it to serve our country and serve our community. You get into public service not for the money but because you want to be part of something greater than yourself.” Katherine Freeman had been working for 10 months as an administrative assistant for the CDC specializing in tuberculosis when she received a mass email saying she had been fired because of her performance. She had received only positive performance reviews and was in line for a promotion. #James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy www.celebratingyourgiftoflife.com Link for 40 Habits Signupbit.ly/40HabitsofMentalHealth If you'd like to follow and receive my daily blog in to your inbox, just click on it with Follow It. Here's the link https://follow.it/james-donaldson-s-standing-above-the-crowd-s-blog-a-view-from-above-on-things-that-make-the-world-go-round?action=followPub “This really knocked me off my feet to get a generic letter that is basically a template. It didn’t even have my name on it. It was just attached to an email,” said Freeman. “To tell people who are performing well that they’re being terminated for poor performance and you’re not getting a severance package, that’s just a cruel way to to handle your employees. I think that’s what people are upset about.” “Everybody understands that the government needs to spend less money, and we get that. But if you’re going to do a layoff, do a layoff the right way.” One VA worker who was just fired, a mother of three young kids, said colleagues all around her are sinking into hopelessness. “You wonder what is going to happen in the world, in general. What will that look like for our children?” she said. “For other people’s kids, they say, ‘It’s not just my life, but my children’s lives. Where are we going?’” A different VA worker who served in the Navy for more than a decade described having dropped 20 pounds in a month and losing her hair. She, like others, described behavior from Musk and Trump as taunting and triggering a sense of powerlessness and anger. Reaching a breaking point, she called a suicide hotline for help. “Serving my vets is what I live for. They need me. They need an understanding person on the other end of the phone call,” said the woman. “I will be destroyed if they fire me.” None of the workers opposed cutting excess. But many described what they saw playing out in their agencies as chaotic and haphazard — like rushing to push boxes off a sinking Titanic without looking at what was inside. Some said their abrupt dismissal would leave programs in the lurch, like those that help farmers or facilitate trade for small businesses. “I’m like so many other government employees I talked to. It’s their f-----g mission in life to help veterans who are struggling. Please quote me on that,” the VA suicide prevention manager said. “I’ve yet to have a person that can, to my face, tell me that my job is not needed. I just tell people what I do and ask them to explain to me: What part of my job is waste or fraud?” The defense employee, whose job entails refurbishing and updating technology on Navy ships, said the constant attack on federal workers has made him want to walk away, move to the private sector and draw a bigger salary. But he recalled during one of his Army tours in Iraq that his unit needed armor reinforcement on its Humvee. A federal worker came through for him in that perilous moment. “I get to do that now, with sailors in the Navy. I’m working to help sailors in the Navy be prepared to engage the Chinese if they go after Taiwan,” the defense worker said. “I’m not going to quit, not going to give up. Because I’m not just giving up on my country, I’m giving up on the sailor and the war fighter that is going to be in immense danger if I do that.” “That’s what a lot of us are remembering: what we do and why we do it, and it’s bigger than this stupid political stuff. This is people’s lives.” If you or someone you know is in crisis, call or text 988 to reach the Suicide and Crisis Lifeline or chat live at 988lifeline.org. You can also visit SpeakingOfSuicide.com/resources for additional support Read the full article

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Photo by Pixabay on Pexels.com By Leanna Coy, FNP-BC Note: This article contains information about the idea of suicide. If you or someone you know is struggling with thoughts of self-harm, help is available. Call or text 988 or chat at 988Lifeline.org Tillamook County Crisis Line: 1-800-962-2851 or 503-842-8201 Older adults and people with disabilities, the Oregon Behavioral Health Initiative has professionals specializing in behavioral health. In Tillamook County, Helen Beaman LCSW, is available at 503-416-4781. News of a suicide can shock and sadden a community. This is especially so in rural areas where the impact is greater due to smaller populations where people are more likely to know each other. One might assume this would translate to fewer suicides in those areas. Quite the opposite is true. Suicides in rural areas are more common that urban areas. Tillamook County has suicide rates higher than both the national and state averages. In 2022, the most recent year statistics are available, nationally there were an average of 14.2 suicides for every 100,000 people. In Oregon, that rate increased to 19.3 for every 100,000. In rural Tillamook County, we had 33.2 per 100,000. At the Pioneer, we hope to bring attention to this issue by talking about it. This article is part of a series openly discussing the topic of suicide. The goal is to empower those struggling to seek help. Suicide is a public health issue Suicide is a public health issue that many people find difficult to talk about. Suicide is death caused by an act of self-harm that is intended to end in death. In the United States, there are nearly twice as many suicides as homicides. Suicide ranks as the 10th leading cause of death in Oregon. Among teens, it is the 2nd leading cause of death. In Oregon, certain groups are more at risk for suicide. These include: - People living in rural and remote communities - Veterans, who comprise nearly 1/3 of all suicides in Oregon - Men, especially older men, have more suicide deaths - Women have more suicide attempts - People of American Indian and Alaska Native Americans descent - Non-Hispanic White individuals - People in the LGBTQ2SIA+ community Dealing with stigma Often, a stigma is attached to suicide due to long-standing religious or moral beliefs. Suicide is commonly linked to mental health conditions, which have their own stigma. We need to move past that because research shows 46% of people who die by suicide had a known mental illness. Mental illness is a condition affecting someone’s thinking, behavior, mood, or feelings. Mental health issues greatly impact a person’s daily activities and can affect how a person interacts and relates to others. Mental health conditions linked to suicide include: - Depression - Substance abuse - Psychosis - Anxiety - Personality disorders - Eating disorders - Trauma related disorders Mental illness is not a character weakness or flaw. Someone is not less of a person for having a mental illness. “Normal” people have mental health issues. - 1 out of every 5 adults experience mental illness every year - Every year 1 out of every 6 children ages 6-17 experience a mental health issue - 75% of lifetime mental illness begins by the age of 14 With one out of every 5 adults experiencing mental illness, you or someone you know is likely dealing with an issue. Many factors play into mental health, including genetics, lifestyle, and environment. Traumatic life events, stress, and certain living situations make someone more likely to develop a mental illness. Frequently, those at risk for suicide are dealing with a combination of difficult life events and mental illness. Why suicide rates are high in rural areas Research shows for more than twenty years, rates of suicide in rural areas have been higher than in urban ones. Between 2000 and 2020, rates of suicide increased by 27.3% in metropolitan areas but jumped 46% in rural areas. Many factors go into why rates are higher outside of the cities: - Cultural issues: The stigma related to acknowledging mental health issues or in seeking mental health care falls here. Traditional gender roles and expectations are strong in some rural communities, which can impact opportunities for women and those in the LGBTQ+ communities. Rural men are known to present as stoic, pushing through their issues without seeking help. - Living in isolated locations: This reduces a sense of connection with others. Living remotely can also make it harder for someone to access available resources due to transportation issues or proximity. - High cost of services: More people will lack insurance or have inadequate coverage to cover the cost of health care. - Physical health: Rural communities have more people working in labor-intensive jobs. In Tillamook County, this would include crabbing, logging, farming, and housekeepers cleaning vacation homes, among many other jobs. Years of labor-intensive work contributes to more chronic pain or disability. - Agricultural factors: Natural disasters such as drought, flooding, or wildfires can put economic pressure and lead to a sense of helplessness. - Easy access: Access to firearms and pesticides are often greater in rural communities than in urban ones. #James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy www.celebratingyourgiftoflife.com Link for 40 Habits Signupbit.ly/40HabitsofMentalHealth If you'd like to follow and receive my daily blog in to your inbox, just click on it with Follow It. Here's the link https://follow.it/james-donaldson-s-standing-above-the-crowd-s-blog-a-view-from-above-on-things-that-make-the-world-go-round?action=followPub Caring for the community Accessing care for mental health issues is a major problem. A shortage of primary care and mental health providers was made worse by pandemic. More than 49% of Americans live in an area where there is a shortage of mental health providers. Tillamook County has one mental health provider for every 400 people. The average in Oregon is one provider for every 210 people. Virtual visits, also known as telehealth, gained popularity during the pandemic. This type of visit helps improve access to care for many living remotely. This type of visit also helps someone who is worried about the stigma associated with mental illness receive treatment in the privacy of their home. However, internet reliability in more remote areas can make this type of visit difficult or impossible for some. We need to overcome any stigma around suicide and mental health. Talking openly about these issues will help increase awareness and normalize the conversation. If you are struggling, seek help. Talk with a friend, family member, or reach out to one of the help lines. If you are concerned about someone at risk for suicide, start the conversation. Photo by Pixabay on Pexels.com Read the full article

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Signs of trauma and tips for helping kids who've been traumatized Writer: Caroline Miller Clinical Expert: Jamie Howard, PhD What You'll Learn - What kinds of trauma tend to affect kids in the classroom? - Which skills do traumatized kids need the most help with at school? - How can teachers help kids after they’ve been hurt by trauma? - Quick Read - Full Article - Trauma and trouble forming bonds - Poor self-regulation - Negative thinking - Hypervigilance - Executive function challenges - Focus on positive attention For many kids who suffer from trauma, it’s not one event. Often, it’s ongoing abuse or neglect. This could be violence at home or in their neighborhood. For some, it’s not having a place to sleep. Trauma affects the way kids act in classrooms. Children who’ve gone through trauma are good at hiding pain. Instead, it comes through in ways that look like misbehavior or even ADHD. When kids learn not to trust adults, they struggle to connect with teachers. They don’t ask for help. They may be jumpy, always looking out for danger. Because it can seem like they’re acting out, schools are quick to punish them. Instead, these kids need teachers to show that you understand how they’re feeling. One way to help is by naming the feeling you see the child expressing. It’s okay if you’re wrong. They’ll probably correct you. Babies learn to calm themselves when grown-ups soothe them. If a child never had an adult soothe them, they can get to school age unable to cope with big feelings. They’ll need help from a teacher to calm down before they learn to do it themselves. Traumatized kids often see things in the worst light. They may think they’re bad kids. Or that people are out to get them. They may be so afraid of making mistakes that they won’t try an activity at all. They need help to see that that they’re good kids who deserve to do well. Kids with trauma can have trouble focusing and thinking things through. They may also act out for attention, even negative attention. It can help when teachers give a lot of positive attention instead. That includes giving them lots of kindness and loving care “just because,” not just when they do something right. We tend to think of trauma as the result of a frightening and upsetting event. But many children experience trauma through ongoing exposure, throughout their early development, to abuse, neglect, homelessness, domestic violence, or violence in their communities. And it’s clear that chronic trauma can cause serious problems with learning and behavior. Trauma is particularly challenging for educators to address because kids often don’t express the distress they’re feeling in a way that’s easily recognizable — and they may mask their pain with behavior that’s aggressive or off-putting. As Nancy Rappaport, MD, a child and adolescent psychiatrist who focuses on mental health issues in schools, puts it, “They are masters at making sure you do not see them bleed.” Identifying the symptoms of trauma in the children can help educators understand these confusing behaviors. And it can help avoid misdiagnosis, as these symptoms can mimic other problems, including ADHD and other behavior disorders. In brief, the obstacles to learning experienced by these children include: - Trouble forming relationships with teachers - Poor self-regulation - Negative thinking - Hypervigilance - Executive function challenges Trauma and trouble forming bonds Children who have been neglected or abused have problems forming relationships with teachers, a necessary first step in a successful classroom experience. They’ve learned to be wary of adults, even those who appear to be reliable, since they’ve been ignored or betrayed by those they have depended on. “These kids don’t have the context to ask for help,” notes Dr. Rappaport, a school consultant and associate professor of psychiatry at Harvard Medical School. “They don’t have a model for an adult recognizing their needs and giving them what they need.” Many of these children haven’t been able to develop secure attachments to the adults in their lives, adds Jamie Howard, PhD, a clinical psychologist and head of the Trauma and Resilience Service at the Child Mind Institute. They need help to let other adults into their lives. “Kids who’ve never developed that early template that you can trust people, that you are lovable and that people will take care of you,” Dr. Howard explains, “need support to form that kind of relationship.” One of the challenges in giving that support is that when kids misbehave, our schools often use disciplinary systems that involve withdrawing attention and support, rather than addressing their problems. Schools have very little patience for kids who provoke and push away adults who try to help them. Instead of suspending children, Dr. Rappaport argues, schools need to work with them on changing their behavior. When a student is acting up in class, she explains, teachers need to recognize the powerful feelings they are expressing, if inappropriately. Rather than jumping right into the behavior plan — deducting points or withdrawing privileges or suspending — Dr. Rappaport stresses the importance of acknowledging the emotion and trying to identify it. “I can see that you are REALLY angry that Andrew took the marker you wanted!” she suggests. “If you’re wrong about what the student is upset about, he’s likely to correct you.” Acknowledging and naming an emotion helps children move towards expressing it in a more appropriate way. Communicating that you “get” them is the necessary first step, she explains, to helping kids learn to express themselves in ways that don’t alienate and drive away people who can help them. Poor self-regulation Traumatized children often have trouble managing strong emotions. As babies and toddlers, children learn to calm and soothe themselves by being calmed and soothed by the adults in their lives, Dr. Howard notes. If they haven’t had that experience, because of neglect, “that lack of a soothing, secure attachment system contributes to their chronic dysregulation.” In the classroom, teachers need to support and coach these children in ways to calm themselves and manage their emotions. “We need to be partners in managing their behavior,” Dr. Rappaport explains. “Co-regulation comes before self-regulation. We need to help them get the control they need to change the channel when they’re upset.”  They need coaching and practice at de-escalating when they feel overwhelmed, she adds. Negative thinking Another challenge to traumatized kids is that they develop the belief that they’re bad, and what’s happened to them is their fault. This leads to the expectation that people are not going to like them or treat them well. As Dr. Howard puts it, “I’m a bad kid. Why would I do well in school? Bad kids don’t do well in school.” Traumatized kids also tend to develop what Dr. Howard calls a “hostile attribution bias” — the idea that everyone is out to get them. “So if a teacher says, ‘Sit down in your seat,” they hear it as, ‘SIT DOWN IN YOUR SEAT!’” she explains. “They hear it as exaggerated and angry and unfair. So they’ll act out really quickly with irritability.” As Dr. Rappaport puts it: “They see negative where we see neutral.” To counter this negative thinking, these students a narrative about themselves that helps them understand that they’re not “bad kids.” And learning to recognize their negative patterns of thought, like black and white thinking, is a step towards being able to change those patterns. Dr. Rappaport notes that children from abusive homes are sometimes unable to participate in classroom activities because they are paralyzed by fear of making a mistake, and that can make them appear to be oppositional. “A mistake that might seem trivial to us becomes magnified,” she explains, “if their experience has been that minor mistakes incurred adult anger or punishment.” They need not only support to have incremental successes they can build on in the classroom, but help to see that in this setting, making a mistake is considered a necessary part of learning. Hypervigilance One of the classic symptoms of trauma is hyper-vigilance, which means being overly alert to danger. “It’s physiological hyper-arousal,” explains Dr. Howard. “These kids are jumpy, they have an exaggerated startle response. They can have some big, out-of-control seeming behaviors, because their fight or flight response has gone off.” This can look like hyperactivity, she adds, leading kids who have been traumatized to be misdiagnosed with ADHD. Being chronically agitated can lead to difficulty with sleeping and chronic irritability. In workshops, Dr. Rappaport coaches teachers on how to help kids to settle down when something in the classroom triggers an emotional outburst. When a child is escalating, the key, she says, is to “match their affect, but in a controlled way.” The goal is to connect to their big feeling. “If you can connect with what they’re trying to tell you, they may settle. It can work even if you just make a guess — you don’t have to be right, they can correct you.” Executive function challenges Chronic trauma affects children’s memory, their ability to pay attention, plan, think things through, and other executive functions. Kids who have ADHD as well as trauma may be especially impaired in these skills. Difficulty planning impacts not only completing tasks in school, but a child’s ability to plan his behavior, rather than acting impulsively, and deciding on the best way to communicate his needs and feelings. One of the things that tends to upset kids who’ve been traumatized is difficulty predicting the future — not knowing what is coming is unsettling for children and creates anxiety. These kids can benefit, Dr. Rappaport notes, from repeated dry runs of what’s coming up and what they should expect. Another executive function that may be weak is the ability to self-narrate — to mentally talk themselves through what they need to do as they are carrying out a task. It’s a skill young children learn from listening to their parents talk to them when they are babies, and, she notes, if they haven’t had the experience they may need help developing the skill. Focus on positive attention In addition to connecting with kids who’ve been traumatized, and helping them build missing skills, Dr. Rappaport emphasizes the importance of giving them as much positive attention as possible. Kids who have experienced chronic neglect tend to be better at getting attention by provoking the adults they depend on than by complying with expectations. “Negative attention is fast, predictable and efficient,” she notes. “We need to make positive attention as fast, predictable and efficient.” But she adds that positive attention includes not only praising them for desired behavior but expressing warmth and kindness that aren’t necessarily earned. Surprising kids with “random acts of kindness” can help wean them from habits of acting out to get attention. “When a kid is acting out and sucking the oxygen out of a classroom,” she notes, “some teachers have found it works to set their phones to buzz every 5 minutes to give the kid positive attention.” Dr. Rappaport offers tools for understanding and managing disruptive behavior in the classroom in her book, The Behavior Code: A Practical Guide to Understanding and Teaching the Most Challenging Students, written with behavioral analyst Jessica Minahan. #James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy Link for 40 Habits Signupbit.ly/40HabitsofMentalHealth If you'd like to follow and receive my daily blog in to your inbox, just click on it with Follow It. Here's the link https://follow.it/james-donaldson-s-standing-above-the-crowd-s-blog-a-view-from-above-on-things-that-make-the-world-go-round?action=followPub Frequently Asked Questions How does trauma affect behavior in kids? Trauma can affect behavior in kids by causing hypervigilance, trouble managing emotions and forming relationships with other people, and difficulty with executive functioning. Read the full article

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Photo by Pixabay on Pexels.com By Leanna Coy, FNP-BC Note: This article contains information about the idea of suicide. If you or someone you know is struggling with thoughts of self-harm, help is available. Call or text 988 or chat at 988Lifeline.org Tillamook County Crisis Line: 1-800-962-2851 or 503-842-8201 Older adults and people with disabilities, the Oregon Behavioral Health Initiative has professionals specializing in behavioral health. In Tillamook County, Helen Beaman LCSW, is available at 503-416-4781. News of a suicide can shock and sadden a community. This is especially so in rural areas where the impact is greater due to smaller populations where people are more likely to know each other. One might assume this would translate to fewer suicides in those areas. Quite the opposite is true. Suicides in rural areas are more common that urban areas. Tillamook County has suicide rates higher than both the national and state averages. In 2022, the most recent year statistics are available, nationally there were an average of 14.2 suicides for every 100,000 people. In Oregon, that rate increased to 19.3 for every 100,000. In rural Tillamook County, we had 33.2 per 100,000. At the Pioneer, we hope to bring attention to this issue by talking about it. This article is part of a series openly discussing the topic of suicide. The goal is to empower those struggling to seek help. Suicide is a public health issue Suicide is a public health issue that many people find difficult to talk about. Suicide is death caused by an act of self-harm that is intended to end in death. In the United States, there are nearly twice as many suicides as homicides. Suicide ranks as the 10th leading cause of death in Oregon. Among teens, it is the 2nd leading cause of death. In Oregon, certain groups are more at risk for suicide. These include: - People living in rural and remote communities - Veterans, who comprise nearly 1/3 of all suicides in Oregon - Men, especially older men, have more suicide deaths - Women have more suicide attempts - People of American Indian and Alaska Native Americans descent - Non-Hispanic White individuals - People in the LGBTQ2SIA+ community Dealing with stigma Often, a stigma is attached to suicide due to long-standing religious or moral beliefs. Suicide is commonly linked to mental health conditions, which have their own stigma. We need to move past that because research shows 46% of people who die by suicide had a known mental illness. Mental illness is a condition affecting someone’s thinking, behavior, mood, or feelings. Mental health issues greatly impact a person’s daily activities and can affect how a person interacts and relates to others. Mental health conditions linked to suicide include: - Depression - Substance abuse - Psychosis - Anxiety - Personality disorders - Eating disorders - Trauma related disorders Mental illness is not a character weakness or flaw. Someone is not less of a person for having a mental illness. “Normal” people have mental health issues. - 1 out of every 5 adults experience mental illness every year - Every year 1 out of every 6 children ages 6-17 experience a mental health issue - 75% of lifetime mental illness begins by the age of 14 With one out of every 5 adults experiencing mental illness, you or someone you know is likely dealing with an issue. Many factors play into mental health, including genetics, lifestyle, and environment. Traumatic life events, stress, and certain living situations make someone more likely to develop a mental illness. Frequently, those at risk for suicide are dealing with a combination of difficult life events and mental illness. Why suicide rates are high in rural areas Research shows for more than twenty years, rates of suicide in rural areas have been higher than in urban ones. Between 2000 and 2020, rates of suicide increased by 27.3% in metropolitan areas but jumped 46% in rural areas. Many factors go into why rates are higher outside of the cities: - Cultural issues: The stigma related to acknowledging mental health issues or in seeking mental health care falls here. Traditional gender roles and expectations are strong in some rural communities, which can impact opportunities for women and those in the LGBTQ+ communities. Rural men are known to present as stoic, pushing through their issues without seeking help. - Living in isolated locations: This reduces a sense of connection with others. Living remotely can also make it harder for someone to access available resources due to transportation issues or proximity. - High cost of services: More people will lack insurance or have inadequate coverage to cover the cost of health care. - Physical health: Rural communities have more people working in labor-intensive jobs. In Tillamook County, this would include crabbing, logging, farming, and housekeepers cleaning vacation homes, among many other jobs. Years of labor-intensive work contributes to more chronic pain or disability. - Agricultural factors: Natural disasters such as drought, flooding, or wildfires can put economic pressure and lead to a sense of helplessness. - Easy access: Access to firearms and pesticides are often greater in rural communities than in urban ones. #James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy www.celebratingyourgiftoflife.com Link for 40 Habits Signupbit.ly/40HabitsofMentalHealth If you'd like to follow and receive my daily blog in to your inbox, just click on it with Follow It. Here's the link https://follow.it/james-donaldson-s-standing-above-the-crowd-s-blog-a-view-from-above-on-things-that-make-the-world-go-round?action=followPub Caring for the community Accessing care for mental health issues is a major problem. A shortage of primary care and mental health providers was made worse by pandemic. More than 49% of Americans live in an area where there is a shortage of mental health providers. Tillamook County has one mental health provider for every 400 people. The average in Oregon is one provider for every 210 people. Virtual visits, also known as telehealth, gained popularity during the pandemic. This type of visit helps improve access to care for many living remotely. This type of visit also helps someone who is worried about the stigma associated with mental illness receive treatment in the privacy of their home. However, internet reliability in more remote areas can make this type of visit difficult or impossible for some. We need to overcome any stigma around suicide and mental health. Talking openly about these issues will help increase awareness and normalize the conversation. If you are struggling, seek help. Talk with a friend, family member, or reach out to one of the help lines. If you are concerned about someone at risk for suicide, start the conversation. Photo by Pixabay on Pexels.com Read the full article

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An open letter about what the ER can (and can't) do for your child in a psychiatric emergency Writer: Julia Johnson Attaway What You'll Learn - What happens at the ER in a psychiatric emergency? - What will a visit to the ER do to help your child? What won’t it do? - What is the parents’ role at the ER? - Quick Read - Full Article - Assessing safety - If you are told your child has a suicide plan - If outpatient treatment is recommended - Plans for follow-up care - If you disagree with the doctor’s safety assessment - About short-term observation - If inpatient treatment is recommended Taking a child to the Emergency Room in a psychiatric emergency is scary and upsetting. But taking your child to the ER doesn’t mean you’re a failure — it means you’re doing everything you can to keep your child safe. Doctors at the ER won’t diagnose what’s distressing your child or offer treatment. Their goal will be to assess your child’s safety and outline next steps. If your child has thoughts about suicide but hasn’t made a plan or an attempt, they will probably be sent home with a referral for out-patient treatment. If they do have a plan for suicide or have made an attempt, they will more likely be sent for in-patient treatment at a hospital until doctors think it is safe for them to go home. If you disagree with the doctor’s assessment, say so loud and clear, and be specific about why you’re worried. Before you leave, you can ask the hospital for help setting up a follow-up appointment for your child. Contacting the hospital social worker or patient advocate can help. It’s also important to make plans for how to proceed at home. What behavior should prompt a return to the ER? What resources can help you between now and your child’s next therapy appointment? And remember, it’s important to be kind to yourself during this difficult time. Dear Parent, You are not a failure because you have taken your child to the ER. You may feel terrified and ashamed, but you are not a failure. You are, in fact, a hero. You have done the brave thing, the hard thing, the only thing you knew to do to keep your child safe. That is honorable. So if anyone — relative, friend or acquaintance — tells you in the next few days that you overreacted, or that your child simply needs more discipline, or that it’s all in your kid’s head, you have the right to say, gently and firmly, “Please don’t be critical. It’s not like I wanted to go. I am scared and I really need your support.” If that person can’t be helpful to you in this strange new world, find someone else who can. Since you’re here, and heaven knows you have time, it might help to have a few pointers so you know what to expect. You see, an emergency room visit for psychiatric issues works a bit differently than one for a physical problem. First — and this is hard — you need to know that they are not going to fix anything. There’s no psychiatric equivalent of setting a broken leg or removing a ruptured appendix. There are no blood tests or lab results to tell you what’s wrong (though they may take blood to check for physical problems that could be contributing to your child’s difficulty). You’re probably going to walk out of here without having a diagnosis, and even without medication. You will have a better understanding of how dangerous your child’s situation is, and what the best course of action is going forward. Assessing safety The primary thing the doctors do here is assess the safety of your child. The key question they will be trying to answer is whether or not your child is an imminent danger to themselves or others. This assessment centers on three main issues: thoughts, plans and intent. - If your child has intrusive thoughts about dying or about doing harm and is upset but doesn’t intend to do anything, they require ongoing care, probably on an outpatient basis. Many teens who cut themselves fall in this category (cutting, while a profoundly disturbing behavior, is not necessarily an indicator of suicidal intent). Kids who are depressed but not actively suicidal, and those who are verbally explosive, often fall in this category as well. Weird as it may seem, this is relatively good news. You will most likely be going home with a recommendation for follow-up care with a therapist. - If your child wants to harm themselves or others yet doesn’t have a plan, that’s a step higher on the worry scale. Risk factors that doctors consider in gauging the best course of action include how impulsive your child is, their recent pattern of behavior, and any known triggers in the home or school environment that could lead to a crisis. - If your child has ideas about how to harm themselves or others but no firm plans to put those plans into action, this is more concerning. If you are sent home, be sure you ask what kinds of methods are lurking in your child’s mind so that you know how to minimize the risks of action. - If your child has a plan for suicide or harm to others, has made an attempt or is acting in a highly impulsive manner that makes an attempt likely, hospitalization is almost always required. This is because everyone’s No. 1 priority is to keep your child safe and alive. The doctors will make this safety assessment by talking with you and your child. At some point you will be asked to step out of the room so that the doctors can speak privately with your child. That’s okay. Doctors do this because it is not uncommon for a child to reveal a suicide plan to doctors that the parent knew nothing about. Do not feel guilty if your child tells a stranger things you didn’t know. Kids love their parents and often fear hurting them, so they don’t want to tell you about their deepest pains because they want to “protect” you from the truth. If you are told your child has a suicide plan Allow yourself time and space to grieve. To avoid distressing your child with your tears, you can excuse yourself to get a cup of coffee, pick up something to eat, or call your significant other. Ask a nurse for tissues and a place you can cry. Your child will be safe while you are gone. It’s OK to leave for a while. Just remember to bring back the coffee or whatever it was you said you’d gone to get! And remember to be thankful that you brought your child to the hospital: You did the right thing. After you have fallen apart and pulled yourself more or less together again, go back in to your child and say, very gently, “The doctors told me you have a suicide plan. I am so, so sorry you are hurting that much. I love you, and even if you can’t see how life is worth living right now, I can see many beautiful things still inside you. I love you very much. I am so glad we came to get help.” And then you can cry, together. Or not. Make sure you write down the names of all the doctors who speak to your child. Take notes of everything they say. Your emotions are running too high to process everything — or even anything — that’s coming at you right now, so write it all down. If outpatient treatment is recommended If you are advised to seek outpatient treatment, you probably won’t be given advice on how to manage life at home better between when you leave the hospital and when you walk into your child’s first therapy appointment. It is appropriate to ask if there are books you should read or websites to explore that would help you handle your situation better. If the doctor doesn’t have suggestions, look at some of the free booklets online at SAMHSA.gov, and explore childmind.org and NAMI.org for helpful information. You will probably be told to bring your child back to the hospital if they exhibit dangerous behavior. Ask the doctor to explain exactly what that means and for rules of thumb so that you know the difference between what feels dangerous to you and what merits a return visit. The doctor may not be particularly helpful with this. Few medical professionals have ever parented a mentally ill child, and they may not know the reality of what your life at home is like. At a minimum, if your child has violent rages, ask to be shown how to hold them in a way that minimizes your risk of getting hurt. You may (or may not) be told to lock up sharps and medications when you go home, or to remove things that can be used to hang or suffocate oneself. When you go home you should quietly do this anyway: Making it less easy to commit suicide reduces the likelihood of disaster arising from impulsive behavior. You might also want to block how-to sites on suicide from your kid’s computer and phone. The internet has a lot of good information, but it’s also full of bad ideas. Plans for follow-up care If your child doesn’t already have an outpatient team, try to have the hospital set up a followup appointment with a provider before you leave.  If you are in the ER in the evening or on a weekend, ask for the name of the social worker at the hospital who will be arranging the follow-up appointment, and get their direct phone number. Call the social worker first thing the next business day. Call again two hours later. Call however often you need to call until you get the appointment set. If you are not getting a response, consider contacting the patient advocate at the hospital. If the hospital says they don’t have enough staff to arrange an appointment, ask to speak to a patient advocate. You may not win the battle, and if you don’t (or simply don’t have the energy to fight), ask a good friend or close relative to make the appointment for you. Make sure that the clinic takes your insurance. Make sure that you can actually get there; in some parts of the country services are few and far between. If you want to use a therapist in private practice, you will have to find one yourself and make your own arrangements. Before you go this route, you need to know that many private therapists do not accept insurance. They will provide receipts so you can seek out-of-network reimbursement, but that only helps if your plan allows out-of-network costs and you have enough cash flow to wait for reimbursement. The cost, depending on where you live and what kind of professional you need, can be anywhere from $100 to $400 a week. If medication is also required, you will need to find and pay for a pediatric psychiatrist, too. You may find it wise to take whatever clinic appointment the hospital offers even if you plan to go private, so you are getting some sort of help while you get your longer-term plan in order. If you disagree with the doctor’s safety assessment If you feel your child is a suicide risk or may hurt others, make your opinion known loud and clear. Be specific about your concerns: Cite information your child may have confided to you, and note recent patterns of behavior that indicate things are getting worse. If your child sees a therapist regularly and the therapist can visit you in the ER, ask the doctors doing the hospital evaluation to speak with that therapist (you will have to sign a release so they can share information). If they still do not agree to hold your child, ask who is liable if your child makes a suicide attempt within the next 48 hours. You can also consider writing the words, “Parent has communicated to medical staff that they feel the child is not safe to return home” on the discharge papers before signing. About short-term observation Some hospitals have a short-term observation unit where a child can be held for up to 72 hours. In some places this is called a Comprehensive Psychiatric Emergency Program (CPEP). When a child is at high risk yet it’s not clear if inpatient treatment is needed, a couple of days in a low-stress environment like this (almost no activities, no therapy, 24-hour observation, and a lot of television) may be a viable option. #James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy www.celebratingyourgiftoflife.com Link for 40 Habits Signupbit.ly/40HabitsofMentalHealth If you'd like to follow and receive my daily blog in to your inbox, just click on it with Follow It. Here's the link https://follow.it/james-donaldson-s-standing-above-the-crowd-s-blog-a-view-from-above-on-things-that-make-the-world-go-round?action=followPub If inpatient treatment is recommended If your child is admitted for inpatient care, at some point you will want to excuse yourself to “get a cup of coffee” and cry. If you break down in front of your child, they’re likely to feel guilty and at fault for hurting you. Right now your kid needs you to be brave, because if there’s one thing scarier than being the parent of a kid going into the psych ward, it’s being the kid who will actually be there. It may take a day or two or even more for a bed to open up (especially if you arrived late in the day, on a Friday, or near a holiday). This means your kid may be in the ER for a long time. You can use this interlude to organize your thoughts, scribble down notes about the sequence of events in recent months and to remember that Uncle Harry was depressed for many years and depression can be hereditary. In most cases, the bed will be in a different facility. Before the social work team starts looking for a spot, ask what the options are. In some cases, one facility may be far away while another is closer, or one may have 12 beds (presumably less chaotic) instead of 24. It’s fair to ask which units have the best reputation. This is because the doctor in the ER may never have been to any of the facilities and may never have treated someone released from there. Older teens may be eligible for either adolescent or adult units. When possible, opt for adolescent. The severity of illnesses on an adult ward is likely to be more extreme. If you have a long wait until a bed is found, do not feel that you have to stay in the ER with your child the whole time. Pop out for dinner and trade off with other family members. Allow your child some space. Your kid is probably going to watch television most of the time, anyway, and you need to take care of yourself. Go home and pick up your child’s toothbrush, toiletries (nothing in glass bottles), pj’s (no drawstrings), underclothes, slippers or socks or shoes without laces, and a couple of days’ worth of clothes. Don’t bring their favorite sweater or favorite pair of jeans; you don’t want to taint them by association with the hospital. Besides, things do sometimes get lost or stolen. Bring magazines, puzzle books, or other forms of entertainment; electronics will not be permitted on the unit. You might want to bring some food for your child, too, since hospital grub isn’t the best. And be kind to yourself. Remember, you are not a failure. What you are doing is heroic. Important:If you or someone you know needs help now, call 988 to reach the Suicide and Crisis Lifeline. Read the full article

[tallmantall]

By Katia Riddle Gabriel Dorvil, 14, has struggled mightily with his mental health. He is already 6'4" tall and often mistaken for an adult. A curriculum at church has helped him accept himself and deal with how people sometimes react to him. If you or someone you love is experiencing a crisis, call or text 9-8-8  for the Suicide and Crisis Lifeline. The staff at First Corinthian Baptist Church felt they had no choice but to tackle the issue of adolescent suicide risk in their congregation. "Just the amount of phone calls we were getting," says Lena Green, who oversees mental wellness programs at the church in Harlem, New York. "I was probably getting almost 10 calls a week asking for services for teens." She referred families to outside clinics and therapists, but they kept returning to her, unable to get the help and services they needed. More than one parent told her they were scared of going to sleep — fearful they would lose their child to suicide overnight. "When we started getting calls about suicide attempts," says Green, "I was like, 'Oh, this is really bad.'" Lena Green has a doctorate in social work and is called Dr. Green by everyone at First Corinthian, where she leads an extensive mental wellness effort for teens and adults. In recent years, experts have sounded alarms about the mental well-being of teenagers of all races. Research from the Centers for Disease Control and Prevention shows escalating rates of mental illness among adolescents since 2010. Suicide is now among the top three leading causes of death for children ages 15-19. Historically, Black teens were thought to be more insulated from suicide risk than their white peers. But experts caution this is no longer the case, with rates of suicide in this racial group increasing more rapidly than any other — one study showed a rise of 144 percent between 2007 and 2020. Despite widespread concern about the issue of teen mental health and suicide in the media and among advocates, research has not yielded definitive answers, so far, about its causes or how to address the problem. Some experts have been alarmed about the deficit of strategies that target Black communities specifically, given the especially steep rise in suicide risk for this population. "Despite a growing body of research on Black youth suicide and mental health," wrote researcher Michael Lindsey in a 2019 report for a congressional taskforce on this issue "news coverage of suicide trends among American youth too often fails to mention specific developments related to Black youth suicide, which urgently need addressing." At First Corinthian Baptist Church, staff take a direct approach. They work to help kids recognize a mental health crisis or prevent it altogether. First Corinthian is one of more than a dozen churches across the country that has participated in a national pilot, to study an intervention known as HAVEN Connect, to reduce suicide risk among young people. "We know the Black churches are a trusted institution," says Sherry Molock, a professor of clinical psychology at George Washington University in Washington, D.C. She designed the intervention and is overseeing the research. "We know that they are really poised to help reduce stigma around mental health challenges in general, and suicide in particular." At stake are the lives and wellbeing of teenagers in their congregation and communities — as well as those across the country who are without proven strategies to address this crisis. Causes are unknown, but these teens offer clues One recent day a 16-year-old named Janelle Davis dropped by First Corinthian after school to see Lena Green — everyone in the church refers to her as Dr. Green — she has a doctorate in social work and is a licensed clinical therapist. Kids come by to spend time with her in her office or just chat. "Did you have soda today?" Green teases Janelle. She high fives her when Janelle tells her no. "What? Yes!" Healthy eating is one of many subjects they talk about regularly. A couple years ago, Janelle was going through a rough time. "I started isolating myself from people," she remembers. Her parents were divorcing. Her mother was struggling, and Janelle didn't want to burden her with anything else. "I feel like we weren't really emotionally honest," she says of herself and her mother. Janelle Davis, 16, says she didn't want to worry her mom when she was struggling. She started to have some disturbing thoughts about hurting herself. Janelle wasn't comfortable bringing her struggle up with her mother, but she did feel like she could approach Green, who remembers some of the conversations they had during this time. "We talk a lot about negative thoughts and, you know, negative voices sort of in our head, right?, " says Green. "About whether or not we're worthy — whether or not we should live or die." Green also called Janelle's mother, Certina Robinson. Sitting in the church recently, Robinson remembers the day she got that call. "I ran over here from the Bronx, and that's the first time I heard that she was having struggles with her mental health," says Robinson. She was a newly single mother of four kids, holding down a job as an assistant principal at a school. She says she just hadn't seen the crisis in front of her. "Dr. Green just kept reiterating, 'we want her to live,'" Robinson recalled. "'We want her to be happy. We want her to thrive.'" Certina Robinson is mom to Janelle, Gabby, and Morgan Davis who attend Dr. Lena Green's evening youth group. Robinson says she's since come to understand that stigma about seeking treatment for mental health is something that's passed down through generations. Black families, she says, are especially vulnerable. "?You have to show that you're strong. You have to show that nothing can break you. That's what we're taught." Weakness equals vulnerability. This is a paradox, she says — established as far back as when Black people were enslaved in this country — that prevents people from treating emotional wounds. "It's ?amazing," Robinson says, "how our oppressors got us to avoid the one thing that would actually liberate us." Contending with European beauty standards There is a story that has become lore in the Green-Dorvil family from when their son, Gabriel, was a baby at a doctor's appointment. "He was getting shots," says his mother, Marchelle Green-Dorvil, "He's probably 16 or 18 months old." She remembers the doctor telling her and her husband, "He's going to be a giant." The doctor also gave Gabriel's parents this ominous warning: "People will automatically believe that he's aggressive." Green-Dorvil says the doctor was right on both predictions. Today, people often mistake Gabriel for an adult. "It's a hard concept for even teachers to grasp," says Green-Dorvil. "You're looking at someone that's 6'4", you know, a certain amount of pounds, a huge big frame. This is a 14-year-old child." Gabriel says accepting this quality about himself has been difficult. "I've had to adapt and understand that everybody's not going to see me the same," he says. "I've had to learn how to move around people." There was a period a few years back when Gabriel was really struggling. "I'm usually an extrovert," he says, "but during that time, it was just all shut down. Like I wasn't talking to anybody. I didn't talk to my friends. I didn't go outside. My bed was my best friend." But he did get involved with a program that his aunt, Lena Green, was running at First Corinthian Baptist. Local students fill a classroom for a workshop on journaling for mental health, part of the curriculum for teens at First Corinthian Baptist Church in Harlem, New York City. "Combating European standards of beauty, especially with children of color, has always been a challenge in our community," says Green. Social media, she says, amplifies unrealistic beauty standards, as well as creates pressure on young people to own expensive things that can be out of their and their parents' financial reach. She says the adults in these adolescents' lives can't keep up with unhealthy messages and influences they receive from social media. "They have this device in their hand 24/7." Something to look forward to Certina Robinson credits the church and Dr. Green with saving her daughter's life. "She helped her by giving her something to look forward to in the future," Robinson says of Green's work with Janelle. The Thrive program for teens at First Corinthian Baptist aims to give kids a vocabulary about mental health, help them identify and name emotions, establish healthy boundaries, and articulate their feelings. One recent day, 16-year-old Madison Hillard-James sat and filled out a worksheet that listed categories — things she could control, and things she couldn't: the past, the future, other peoples' opinions and actions. "?I had to set a boundary with a friend around money," she said as a recent example. The friend was constantly hitting her up for loans. She and Green rehearsed what she needed to say. "I can't always give it to you, cause my mom works two jobs. So I just can't be freehanding and giving out money." Madison Hillard-James, 16, says the programs at First Corinthian have helped her navigate friendships and find self-acceptance. It's a small thing, but illustrative of a newfound confidence the teenager gained since participating in the Thrive program. Madison's voice changed and became deeper as she went through puberty. "I was like 'Oh no, I don't like this about myself,'" she says. She started doubting her worth and acting out in school. Then she began attending the teen program at First Corinthian Baptist. Since then, she's worked on embracing her unique qualities rather than hiding them. "I'm a thick girly, I've got a deep voice," she says. "I tried to change it, it didn't work — so I just worked to adjust to it and really feel myself." #James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy www.celebratingyourgiftoflife.com Link for 40 Habits Signupbit.ly/40HabitsofMentalHealth If you'd like to follow and receive my daily blog in to your inbox, just click on it with Follow It. Here's the link https://follow.it/james-donaldson-s-standing-above-the-crowd-s-blog-a-view-from-above-on-things-that-make-the-world-go-round?action=followPub Kinship, guidance, purpose and balance Molock, the clinical psychology professor who designed the national pilot and is also a trained pastor, used insight from programs that successfully reduced suicide in other populations. Molock's curriculum focuses on four pillars: kinship, guidance, purpose and balance. She suspected that the intervention would more effectively reach students through the church than other venues such as school or medical facilities, institutions with which some people of color have had turbulent relationships. "?The specific cultural tailoring of suicide prevention is still in its infancy," says Leslie Adams, who studies Black mental health and suicide risk at Stanford University and is not involved in this project. She says the research that is happening at churches like First Corinthian is groundbreaking. ?While there are known strategies for suicide prevention in other populations, "there are unique vulnerabilities for this population — that they experience this, you know, chronically as kids and then at an everyday basis." Students take part in a workshop on journaling for mental health at First Corinthian Baptist Church in Harlem, New York City. Adams worries that the country's current political and racial climate and the Trump administration's emphasis on ending diversity, equity and inclusion programs across American institutions jeopardize this fragile and emerging body of work. While the program at First Corinthian Baptist receives no federal funding, Adams says the research questions it raises will need to be taken up by institutions such as NIH or CDC in order to continue. "Suicide prevention should not be political," Adams argues, and points out that the risk has broader implications for all of society. "Black Americans are a major part of our labor force, of our society, of our communities," she says. "This is also an economic issue." For the families at First Corinthian Baptist, however, this issue is personal. Marchelle Green-Dorvil says she can easily see how things might have gone a different direction in her family, had they not had the Thrive program. Gabriel Dorvil says it helped him come to understand that he has no control over other people. "They're just not going to see me how my family sees me, how my friends see me," he says, acknowledging that it's instinct rather than reason that drives human behavior. He says he's choosing to honor his own instinct instead — to live. If you or someone you love is experiencing a crisis, call or text 9-8-8  for the Suicide and Crisis Lifeline. Read the full article

[tallmantall]

By Katia Riddle Gabriel Dorvil, 14, has struggled mightily with his mental health. He is already 6'4" tall and often mistaken for an adult. A curriculum at church has helped him accept himself and deal with how people sometimes react to him. If you or someone you love is experiencing a crisis, call or text 9-8-8  for the Suicide and Crisis Lifeline. The staff at First Corinthian Baptist Church felt they had no choice but to tackle the issue of adolescent suicide risk in their congregation. "Just the amount of phone calls we were getting," says Lena Green, who oversees mental wellness programs at the church in Harlem, New York. "I was probably getting almost 10 calls a week asking for services for teens." She referred families to outside clinics and therapists, but they kept returning to her, unable to get the help and services they needed. More than one parent told her they were scared of going to sleep — fearful they would lose their child to suicide overnight. "When we started getting calls about suicide attempts," says Green, "I was like, 'Oh, this is really bad.'" Lena Green has a doctorate in social work and is called Dr. Green by everyone at First Corinthian, where she leads an extensive mental wellness effort for teens and adults. In recent years, experts have sounded alarms about the mental well-being of teenagers of all races. Research from the Centers for Disease Control and Prevention shows escalating rates of mental illness among adolescents since 2010. Suicide is now among the top three leading causes of death for children ages 15-19. Historically, Black teens were thought to be more insulated from suicide risk than their white peers. But experts caution this is no longer the case, with rates of suicide in this racial group increasing more rapidly than any other — one study showed a rise of 144 percent between 2007 and 2020. Despite widespread concern about the issue of teen mental health and suicide in the media and among advocates, research has not yielded definitive answers, so far, about its causes or how to address the problem. Some experts have been alarmed about the deficit of strategies that target Black communities specifically, given the especially steep rise in suicide risk for this population. "Despite a growing body of research on Black youth suicide and mental health," wrote researcher Michael Lindsey in a 2019 report for a congressional taskforce on this issue "news coverage of suicide trends among American youth too often fails to mention specific developments related to Black youth suicide, which urgently need addressing." At First Corinthian Baptist Church, staff take a direct approach. They work to help kids recognize a mental health crisis or prevent it altogether. First Corinthian is one of more than a dozen churches across the country that has participated in a national pilot, to study an intervention known as HAVEN Connect, to reduce suicide risk among young people. "We know the Black churches are a trusted institution," says Sherry Molock, a professor of clinical psychology at George Washington University in Washington, D.C. She designed the intervention and is overseeing the research. "We know that they are really poised to help reduce stigma around mental health challenges in general, and suicide in particular." At stake are the lives and wellbeing of teenagers in their congregation and communities — as well as those across the country who are without proven strategies to address this crisis. Causes are unknown, but these teens offer clues One recent day a 16-year-old named Janelle Davis dropped by First Corinthian after school to see Lena Green — everyone in the church refers to her as Dr. Green — she has a doctorate in social work and is a licensed clinical therapist. Kids come by to spend time with her in her office or just chat. "Did you have soda today?" Green teases Janelle. She high fives her when Janelle tells her no. "What? Yes!" Healthy eating is one of many subjects they talk about regularly. A couple years ago, Janelle was going through a rough time. "I started isolating myself from people," she remembers. Her parents were divorcing. Her mother was struggling, and Janelle didn't want to burden her with anything else. "I feel like we weren't really emotionally honest," she says of herself and her mother. Janelle Davis, 16, says she didn't want to worry her mom when she was struggling. She started to have some disturbing thoughts about hurting herself. Janelle wasn't comfortable bringing her struggle up with her mother, but she did feel like she could approach Green, who remembers some of the conversations they had during this time. "We talk a lot about negative thoughts and, you know, negative voices sort of in our head, right?, " says Green. "About whether or not we're worthy — whether or not we should live or die." Green also called Janelle's mother, Certina Robinson. Sitting in the church recently, Robinson remembers the day she got that call. "I ran over here from the Bronx, and that's the first time I heard that she was having struggles with her mental health," says Robinson. She was a newly single mother of four kids, holding down a job as an assistant principal at a school. She says she just hadn't seen the crisis in front of her. "Dr. Green just kept reiterating, 'we want her to live,'" Robinson recalled. "'We want her to be happy. We want her to thrive.'" Certina Robinson is mom to Janelle, Gabby, and Morgan Davis who attend Dr. Lena Green's evening youth group. Robinson says she's since come to understand that stigma about seeking treatment for mental health is something that's passed down through generations. Black families, she says, are especially vulnerable. "?You have to show that you're strong. You have to show that nothing can break you. That's what we're taught." Weakness equals vulnerability. This is a paradox, she says — established as far back as when Black people were enslaved in this country — that prevents people from treating emotional wounds. "It's ?amazing," Robinson says, "how our oppressors got us to avoid the one thing that would actually liberate us." Contending with European beauty standards There is a story that has become lore in the Green-Dorvil family from when their son, Gabriel, was a baby at a doctor's appointment. "He was getting shots," says his mother, Marchelle Green-Dorvil, "He's probably 16 or 18 months old." She remembers the doctor telling her and her husband, "He's going to be a giant." The doctor also gave Gabriel's parents this ominous warning: "People will automatically believe that he's aggressive." Green-Dorvil says the doctor was right on both predictions. Today, people often mistake Gabriel for an adult. "It's a hard concept for even teachers to grasp," says Green-Dorvil. "You're looking at someone that's 6'4", you know, a certain amount of pounds, a huge big frame. This is a 14-year-old child." Gabriel says accepting this quality about himself has been difficult. "I've had to adapt and understand that everybody's not going to see me the same," he says. "I've had to learn how to move around people." There was a period a few years back when Gabriel was really struggling. "I'm usually an extrovert," he says, "but during that time, it was just all shut down. Like I wasn't talking to anybody. I didn't talk to my friends. I didn't go outside. My bed was my best friend." But he did get involved with a program that his aunt, Lena Green, was running at First Corinthian Baptist. Local students fill a classroom for a workshop on journaling for mental health, part of the curriculum for teens at First Corinthian Baptist Church in Harlem, New York City. "Combating European standards of beauty, especially with children of color, has always been a challenge in our community," says Green. Social media, she says, amplifies unrealistic beauty standards, as well as creates pressure on young people to own expensive things that can be out of their and their parents' financial reach. She says the adults in these adolescents' lives can't keep up with unhealthy messages and influences they receive from social media. "They have this device in their hand 24/7." Something to look forward to Certina Robinson credits the church and Dr. Green with saving her daughter's life. "She helped her by giving her something to look forward to in the future," Robinson says of Green's work with Janelle. The Thrive program for teens at First Corinthian Baptist aims to give kids a vocabulary about mental health, help them identify and name emotions, establish healthy boundaries, and articulate their feelings. One recent day, 16-year-old Madison Hillard-James sat and filled out a worksheet that listed categories — things she could control, and things she couldn't: the past, the future, other peoples' opinions and actions. "?I had to set a boundary with a friend around money," she said as a recent example. The friend was constantly hitting her up for loans. She and Green rehearsed what she needed to say. "I can't always give it to you, cause my mom works two jobs. So I just can't be freehanding and giving out money." Madison Hillard-James, 16, says the programs at First Corinthian have helped her navigate friendships and find self-acceptance. It's a small thing, but illustrative of a newfound confidence the teenager gained since participating in the Thrive program. Madison's voice changed and became deeper as she went through puberty. "I was like 'Oh no, I don't like this about myself,'" she says. She started doubting her worth and acting out in school. Then she began attending the teen program at First Corinthian Baptist. Since then, she's worked on embracing her unique qualities rather than hiding them. "I'm a thick girly, I've got a deep voice," she says. "I tried to change it, it didn't work — so I just worked to adjust to it and really feel myself." #James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy www.celebratingyourgiftoflife.com Link for 40 Habits Signupbit.ly/40HabitsofMentalHealth If you'd like to follow and receive my daily blog in to your inbox, just click on it with Follow It. Here's the link https://follow.it/james-donaldson-s-standing-above-the-crowd-s-blog-a-view-from-above-on-things-that-make-the-world-go-round?action=followPub Kinship, guidance, purpose and balance Molock, the clinical psychology professor who designed the national pilot and is also a trained pastor, used insight from programs that successfully reduced suicide in other populations. Molock's curriculum focuses on four pillars: kinship, guidance, purpose and balance. She suspected that the intervention would more effectively reach students through the church than other venues such as school or medical facilities, institutions with which some people of color have had turbulent relationships. "?The specific cultural tailoring of suicide prevention is still in its infancy," says Leslie Adams, who studies Black mental health and suicide risk at Stanford University and is not involved in this project. She says the research that is happening at churches like First Corinthian is groundbreaking. ?While there are known strategies for suicide prevention in other populations, "there are unique vulnerabilities for this population — that they experience this, you know, chronically as kids and then at an everyday basis." Students take part in a workshop on journaling for mental health at First Corinthian Baptist Church in Harlem, New York City. Adams worries that the country's current political and racial climate and the Trump administration's emphasis on ending diversity, equity and inclusion programs across American institutions jeopardize this fragile and emerging body of work. While the program at First Corinthian Baptist receives no federal funding, Adams says the research questions it raises will need to be taken up by institutions such as NIH or CDC in order to continue. "Suicide prevention should not be political," Adams argues, and points out that the risk has broader implications for all of society. "Black Americans are a major part of our labor force, of our society, of our communities," she says. "This is also an economic issue." For the families at First Corinthian Baptist, however, this issue is personal. Marchelle Green-Dorvil says she can easily see how things might have gone a different direction in her family, had they not had the Thrive program. Gabriel Dorvil says it helped him come to understand that he has no control over other people. "They're just not going to see me how my family sees me, how my friends see me," he says, acknowledging that it's instinct rather than reason that drives human behavior. He says he's choosing to honor his own instinct instead — to live. If you or someone you love is experiencing a crisis, call or text 9-8-8  for the Suicide and Crisis Lifeline. Read the full article

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Photo by samer daboul on Pexels.com - Ziyi Chen,  - Jianhua Zhang,  - Tiancheng Zhang,  - Fulan Zhang,  - Yang Liu,  - Yuanyuan Ma,  - Yiyi Chen &  - Zeng Zhou  Objective This study aims to investigate the longitudinal interplay between early adolescent bullying victimization and suicidal ideation, and to analyze the mediating role of self-efficacy in their dynamic relationship. Methods A cluster sampling method was employed to select 1,023 seventh-grade students from a middle school in an urban district of Hunan Province between March and December 2023. Three waves of data collection were conducted using questionnaires that included scales for adolescent bullying victimization, suicidal ideation (PANSI), and general self-efficacy (GSES). The cross-lagged panel model (CLPM) was utilized to explore the reciprocal relationships between early bullying victimization, suicidal ideation, and self-efficacy. Results Early adolescent bullying victimization was found to both directly and indirectly predict suicidal ideation through its impact on self-efficacy. Conversely, suicidal ideation did not directly predict the level of bullying victimization but was able to indirectly predict it through its effect on self-efficacy. Conclusion The bullying victimization in early adolescents can directly predict the level of suicidal ideation and can also indirectly influence suicidal ideation by affecting self-efficacy; Suicidal ideation does not directly predict the level of bullying victimization; rather, it can indirectly predict bullying victimization through its impact on self-efficacy. Peer Review reports Introduction Suicide continues to be a significant global public health challenge . Among related behaviors, suicidal ideation is often regarded as a precursor to suicide, reflecting an individual’s clear desire to end their life without having acted on it . Recent reports indicate that the prevalence of suicidal thoughts among adolescents worldwide ranges from 8.3 to 31.3%, underscoring a concerning trend . Research suggests that early adolescence is a critical period for the development of suicidal ideation, as individuals often encounter increased academic pressure and changes in their social environment . Adolescents experiencing suicidal thoughts may suffer from negative emotions such as depression, anxiety, and despair, which can lead to self-harm or suicide . This situation can have a profound psychological impact on their families and communities, resulting in adverse social consequences . Given the widespread and harmful nature of suicidal ideation among adolescents, research on early suicidal thoughts in this population is essential. Beyond its impact on adolescents’ mental and physical health, increasing research attention has been given to the mechanisms underlying the development of suicidal ideation . Frequent reports of youth bullying incidents in online and social media have drawn significant academic attention . Bullying victimization, as a crucial factor influencing suicidal ideation, refers to the phenomenon where individuals experience prolonged or repeated harm from others, characterized by its repetitive, intentional nature and power imbalance . Studies indicate that bullying victimization is widespread during adolescence, severely harming the mental and physical development of youth . Prolonged experiences of bullying can deepen levels of suicidal ideation, consequently affecting overall quality of life . Although previous scholars have conducted valuable explorations into the relationship between suicidal ideation and bullying victimization, research examining the early suicidal ideation of adolescents from a longitudinal perspective remains scarce. There is ongoing debate regarding whether the relationship between early bullying victimization and suicidal ideation is mutually predictive or unidirectional . Self-efficacy refers to an individual’s belief in their capacity to navigate specific situations and achieve desired outcomes . As a crucial positive psychological asset in early adolescence, it is widely recognized for its role in promoting healthy behaviors and intervening in problematic behaviors . Recent studies have extensively examined the detrimental effects of low self-efficacy on early health-compromising behaviors among adolescents. On the one hand, low self-efficacy may exacerbate emotional distress, intensifying negative emotions such as depression, hopelessness, and suicidal ideation . On the other hand, low self-efficacy is also viewed as a vulnerability factor for bullying victimization, affecting adolescents’ social adaptability. This may lead individuals to adopt avoidant attitudes towards interpersonal interactions, resulting in marginalization and increased susceptibility to bullying . Notably, there remains a lack of research on the mechanisms underlying the relationship between self-efficacy, bullying victimization, and suicidal ideation, particularly regarding their dynamic characteristics, which require further investigation. In summary, this study proposes the following hypotheses: Hypothesis a: Bullying victimization in early adolescence predicts suicidal ideation. Hypothesis b: Suicidal ideation in early adolescence inversely predicts bullying victimization. Hypothesis a: Bullying victimization in early adolescence predicts suicidal ideation through self-efficacy. Hypothesis b: Suicidal ideation in early adolescence inversely predicts bullying victimization through self-efficacy. Previous studies have predominantly employed cross-sectional designs, failing to adequately reveal the complex relationships among suicidal ideation, bullying victimization, and self-efficacy. Mediation analysis using longitudinal data can address the limitations of cross-sectional studies, providing more reliable evidence for clarifying the interactions and mediating mechanisms among these variables . Therefore, this study aims to construct a Cross-Lagged Panel Model (CLPM) and utilize a three-wave longitudinal survey to investigate the interplay between early suicidal ideation and bullying victimization, analyzing the mediating role of self-efficacy. This research seeks to provide evidence-based insights for the mental and physical health development of adolescents. Materials and methods Participants This study focuses on seventh-grade students from five public middle schools in a district of Hunan Province, China, who have no cognitive impairments and can independently complete questionnaires. Using a random cluster sampling method, we selected five classes from each school, resulting in a total of 1,276 seventh-grade students as the tracking sample. Assessments were conducted in September 2023, March 2024, and September 2024. After excluding invalid questionnaires with missing values or inconsistent responses, 1,023 completed questionnaires with consistent coding across all three assessments were retained as the final valid research sample. This study was approved by the Biomedical Ethics Committee of Jishou University (Approval No. JSDX-2023-0034), and data from the follow-up investigation will be used solely for academic analysis and research purposes. Prior to data collection, the research team contacted the administrative departments of the participating schools to introduce the study’s objectives, methods, and ethical considerations, obtaining written approval from the relevant authorities. In accordance with ethical guidelines for research involving minors, the research team informed all participating students and their parents about the study’s purpose, procedures, and confidentiality measures. Assent was obtained from all student participants, and informed consent was provided by their parents. Procedures The investigators in this study were graduate students from the School of Sports Science at Jishou University, demonstrating strong professional competence and a rigorous work ethic. Before data collection, all investigators received standardized training covering key terminology, questionnaire content, and relevant academic concepts. The assessments were conducted anonymously in classrooms, with questionnaires distributed and collected on-site. Informed consent was obtained from both class teachers and participants before data collection. At the beginning of the assessments, investigators explained the study’s purpose and provided standardized instructions to ensure participants fully understood the questionnaire requirements. Participants were informed that their data would be used exclusively for scientific research and that their personal information would remain confidential. They were encouraged to respond honestly and ask for clarification if needed. Investigators answered these inquiries following the original scale guidelines to ensure accurate completion. Instruments Basic information In this study, participants’ basic demographic information was collected through a questionnaire, including gender, left-behind status and only-child status. Left-behind status was categorized into left-behind adolescents and non-left-behind adolescents. Left-Behind adolescents were defined as those who, in the past six months, had been left in rural areas under the care of other relatives or guardians due to parental labor migration. In contrast, Non-Left-Behind adolescents were those who had lived with both parents during the past six months and had not been separated due to parental migration . Regarding only-child status, an Only-Child was defined as the sole child in a family, with parents having neither biological nor adopted siblings. Conversely, a Non-Only-Child referred to an individual who had at least one biological or adopted sibling within the family structure . Bullying victimization The study utilized a bullying victimization scale from Ji Chengye’s “Comprehensive Survey Report on Health-Related/Risk Behaviors among Chinese Adolescents” . This scale consists of seven items (e.g., “Have you been maliciously teased?“), employing a 4-point Likert scoring system, ranging from 1 = “Never” to 4 = “Always.” It encompasses four dimensions: physical bullying, verbal bullying, relational bullying, and sexual harassment. A higher total score indicates a greater severity of bullying experienced by the individual. In this study, the Cronbach’s alpha coefficients for this scale were 0.91, 0.89, and 0.92 across three assessments. Self-Efficacy The study employed the Chinese version of the General Self-Efficacy Scale (GSES), developed by Schwarzer et al. and translated and revised by Wang Caikang et al. , to assess early self-efficacy in adolescents. The scale consists of 10 items (e.g., “If I try my best, I can always solve problems.“), employing a 4-point Likert scoring system, ranging from 1 = “Not at all true” to 4 = “Exactly true.” A higher total score indicates greater self-efficacy. In this research, the Cronbach’s alpha coefficients for the scale were 0.86, 0.87, and 0.85 across three assessments. Suicidal ideation The study utilized the Positive and Negative Suicide Ideation Scale (PANSI), developed by Osman et al. and translated by Wang Xuezhi et al. , to assess early suicidal ideation in adolescents. This scale contains 14 items (e.g., “Feeling hopeless about the future and having thoughts of suicide.”), employing a 5-point Likert scoring system ranging from 1 = “Never” to 5 = “Often.” Participants rated each item based on their experiences over the past two weeks, which encompass two dimensions: positive suicidal ideation (6 items) and negative suicidal ideation (8 items). Positive suicidal ideation scores are reverse-coded, and the total score is calculated by summing the item scores, with higher scores indicating greater suicidal ideation. In this study, the Cronbach’s alpha coefficients for the scale across three assessments were 0.88, 0.90, and 0.89. Data analysis Statistical analyses were conducted using SPSS 27.0 and Mplus 8.3. Descriptive statistics were performed in SPSS 27.0, with categorical data expressed as frequencies and percentages, and continuous data presented as mean?±?standard deviation (—x±s). Group comparisons were carried out using t-tests or one-way ANOVA. Pearson correlation analysis was employed to examine the relationships between variables. After controlling for demographic factors such as gender, rural residency status, and only-child status, we constructed a cross-lagged model using Mplus 8.3. The cross-lagged model is a statistical approach designed for longitudinal data and is commonly used to test hypotheses and explore causal relationships among variables. By analyzing variable relationships at different time points, this method helps reveal causal directions and mutual influences. In this study, we used autoregressive and cross-lagged regression coefficients to analyze the longitudinal relationship between early suicidal ideation and bullying victimization in adolescents . We employed the bootstrap method to examine the longitudinal mediating effect of self-efficacy between suicidal ideation and bullying victimization. We conducted model estimation using robust maximum likelihood estimation (MLR) and handled missing data with full information maximum likelihood estimation (FIML). We assessed model adequacy using multiple fit indices, including the comparative fit index (CFI), Tucker-Lewis index (TLI), root mean square error of approximation (RMSEA), and standardized root mean square residual (SRMR). According to standard cutoff criteria, CFI/TLI?>?0.90 and SRMR/RMSEA? Read the full article